We rated Nelson Trust as good because:

• Staff were proactive at identifying and managing risk. There were effective systems in place to ensure the management of clients’ risks. Risk assessments and recovery plans were personalised, thorough, and understood by all staff. All staff understood how to report incidents and near misses. Managers reviewed incidents in governance meetings and involved staff in discussing the learning from incidents and implementing change. Incidents were also reviewed by the risk and assurance team.

• The premises were safe for the clients. The managers had completed ligature and environmental risk assessments on the premises in 2018. These were reviewed every six months.
• Care plans and crisis plans were up to date or comprehensive to assist the teams to deliver safe care and treatment to clients. They were holistic, personalised and promoted recovery and met the individual needs of each client. They included physical health care checks from clients’ GPs.

• Clients and their families were encouraged to work together. Families were offered weekend workshops to assist and understand their relative’s recovery. Family members spoken with were very positive about this.
• The service ensured clients were integrated into the local social networks, employment and education opportunities. Many clients remained in the local area after completing their treatment and became part of the community.
• The service ensured there was a wide choice of treatments and clients’ individual needs and preferences were central to the planning and delivery of tailored services. There was an education academy where clients completed educational courses in conjunction with the local college. There was also a maintenance team in the service where clients could learn new skills.

• Senior managers in the service demonstrated clear, effective and inclusive leadership with a strong sense of direction and objectives. All staff spoken with were aware of the developments and direction of the service.
• The board of trustees, the senior management team and the Chief Executive Officer were visible across all sites. They visited the houses and attended community meetings. Clients and staff were confident they could raise concerns with any of the senior management team and they would be acted upon.

However:

• Staff members did not ensure clients had access to advocacy services.